Mental health first-aid training may enhance mental health support in prison settings

According to Rutgers Health researchers, training correctional officers in Mental Health First Aid (MHFA) for adults, a 7.5-hour national education program from the National Council of Mental Wellbeing, may help provide them with the necessary skills to effectively identify signs and symptoms of mental distress and advocate for incarcerated individuals facing mental health crises.

Led by Pamela Valera, an assistant professor in the Department of Urban-Global Public Health at Rutgers School of Public Health, the researchers collaborated with the National Council of Mental Wellbeing to develop the pilot study, published in Psychological Services, to evaluate officers’ mental health knowledge and attitudes before and after undergoing the remote training.

“Correctional officers serve as first responders, working around the clock in three shifts. They are often the initial point of contact for individuals experiencing mental health distress, psychosis, and substance abuse within criminal justice settings,” Valera said. “Despite this critical role, correctional officers typically receive minimal mental health training.”

According to the Substance Abuse Mental Health Services Administration (SAMHSA), it’s estimated that over half of people who are incarcerated have a mental health disorder. Therefore, the need for correctional officers to be trained in mental health is evident. While crisis intervention teams – initially designed for police officers to manage mental health crises in the community – have been adapted for correctional settings, researchers said evidence of their effectiveness remains limited and yields mixed results.

MHFA training, however, is supported by evidence-based interventions and has demonstrated success in enhancing trainees’ mental health literacy and their capacity to identify, understand and respond to mental health crises.

“This study is the first of its kind to implement Mental Health First Aid in a correctional setting,” Valera said. “However, Mental Health First Aid will need to be tailored specifically for correctional professionals to equip them with the ability to identify signs and symptoms of mental health challenges among those incarcerated in either a jail, prison or detention setting to appropriately refer individuals to immediate justice-involved services.”

Using a mixed-methods approach, researchers recruited 30 correctional officers who worked at a northeastern maximum security state prison facility for a MHFA intervention study. Due to the COVID-19 pandemic, the training was conducted remotely via Zoom.

Of these participants, 27 completed the study encompassing pre- and post-surveys alongside a follow-up assessment – and nine correctional officers engaged in a focus group session.

The pre and post-test findings suggest MHFA training improved participants’ ability to distinguish between manifestations of mental health, substance use and behavioral challenges, researchers said. They emphasized the positive impact of MHFA training on correctional officers’ attitudes toward referring incarcerated individuals to mental health professionals.

In the 12 weeks following the intervention, participants self-reported referring incarcerated individuals experiencing signs of mental distress. However, there is a need to enhance the mental health referral process for incarcerated individuals when correctional officers provide MHFA, according to the researchers.

Reflecting on their experience with remote MHFA training, one correctional officer noted, “We should be receiving far more mental health training. We truly need it because our current training doesn’t cover this aspect. I believe everyone should have access to this course. It allowed me to become more introspective, identify what I’ve been overlooking, and address it. More guidance on effective communication with incarcerated people would be beneficial.”

Researchers emphasized the importance of expanding the scope of MHFA training to include various settings, such as county jails and detention facilities. Valera said future MHFA interventions must improve mental wellness in correctional settings.

The study’s co-authors are researchers from the Rutgers School of Public Health, the Rutgers Institute for Health, Health Care Policy and Aging Research, and collaborators from institutions in Washington, D.C.